OTHERS
OTHERS
SCENARIOS
CIW/WGS SCREEN
SCENARIOS
100

Which edit indicates incorrect LAB filing 

ANL

100

Which popup gives us National state of provider 

DS Popup

100

which tab provides provider network

Provider information tab

100

under which tab do we get the documents mlh # of a claim  ?

attachments

100

Claim is not a dup . What do we do in Home lob  ?

We will adjust the claim

200

Which bill type indicates that this is a LATE CHARGE claim ?

5

200

HMO  stands for 

Health Maintenance Organization 
200

Claim A and B is billed with pos 21 and is a IA claims   , for same patient,  for same DOS .  Will this be a dup ?

Yes 

200

under which tab do we get check related details in ciw ?

payment information
200

Methods to search records in WCF 

Member ID with prefix  , Member ID without prefix  , Tax id  ,Health plan transaction ID 

300

Which edit indicates corrected claim submission 

PAJ 

300

What does POS 21 indicate 

Inpatient 

300

Application in which we get records

WCF

300

Under which tab do we get par/non par status of the provider  ?

under claim header tab 

300

Who is the vendor for OH , IN , MO state when we get ACM edit  ?

Novologix

400

Which edits indicates missing REFERING PROVIDER / REFERING PROVIDER LOCATION CORRECTION 

ANL 

400

Which popup provider DX upto 25

HP

400

Application with which we connect with Home plan

B2

400

which tab provides us with sf df rf information ?

b2 data

400

How do we check for pointers in CIW 

Check for diagnosis codes and their placement in Claim line details

500

When claim has HCM edit  , we should send the claim to ?

PPRU 

500

mention the popups in which we get diag pointers for PA claims 

PD 

500

Claim should be paid with 150  , but paid with 155 . Is this underpaid or overpaid 

overpaid

500

Under which  tab do we update comments ?

notes

500

what does CO 253 stand for in Medicare 

Sequestration